FORM Workshop Registration - Half Sheet

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SCRAP Bin
105 Folds Drive, Suite 3
Carrollton, GA 30117
Phone: 770-666-5332
E-mail: scrapbi[email protected]
Workshop Registration Form
Workshop Title: ___________________________ Workshop Date/Time: _________ / _________
Name: __________________________________ Today’s Date: ___________________________
E-mail: _________________________________ Phone: ________________________________
Payment at this time is by check or cash. Please make your check payable to SCRAP Bin and include
payment with this form. You may drop off payment and form at SCRAP Bin or mail it to:
Form and amount of payment received:
Cash
Check # _______
Amount: __________
Photos will be taken for use on the SCRAP Bin website and other public relations materials unless the responsible party indicates otherwise.
form as of March 13, 2011